Open letter to President Obama on Health Care Reform

What does the government have to bring to the table, other than the use of force? What is unique about government action that can help to reduce the cost of health care while making it available to everyone?

The power of law.

And what is a law other than a statement of what people should do, backed by the government’s use of force?

teuchter - 23 July 2009 07:42 PM

I already posted the stats somewhere else but it won’t take you long to look up the infant mortality rate, life expectancy and other indicators of the functioning of the health care systems of the various nations. The US doesn’t look too good, a little third-worldish, if you know what I mean, whereas Europe and Asia do quite fine with their socialized medicine. Canada is in the top few in every category. Go figure!

For one thing, I am not holding up America as a shinign example of a free market health care system. Its got some serious problems which I blame on a vast amount of regulation and government spending.

For another, those statistics are distorted. Infant mortality is measured by different standards in America than in other countries. If a baby is born alive at all, even seriously premature, it is counted as an infant mortality. In many other countries, particularly those third world countries, if a baby is born premature, and dies even weeks after birth, it is often counted as a miscarriage, and not counted in infant mortality statistics. This is actually a consequence of BETTER neonatal care in America. We invest more resources, and thus more of our emotions, in caring for newborns and premature babies, so we think of them more as babies and not miscarried fetuses.

As for life expectancy, that is distorted by a higher rate of car accident deaths in America, and more violence (the violence I blame in part on “progressive” criminal justice and education). Adjusted for those factors, life expectancy in Ameria is as good or better than most countries. Not that that is any reflection on the health care systems. People in some European countries simply live a healthier lifestyle, with less fatty food and more excercise.

And your page 19, once I disciphered it, sounds like the only exception is switching from one insurance company to another. I htink thats what “exchange participating” means. It still sounds like a severe, only slightly less so, restriction on the freedom of Americans to buy private health insurance.

What does the government have to bring to the table, other than the use of force? What is unique about government action that can help to reduce the cost of health care while making it available to everyone?

The power of law.

That is called price fixing. Even the most cursory reading of history will be enough to inform you that it doesn’t work. Attempts at price fixing go all the way back the beginning of written history, and 6000 years of experience certainly ought to be enough to convince people that it doesn’t work. But people keep trying because just as Santayana said, people who don’t learn from the mistakes of the past are doomed to repeat them. And so people inevitably try it again.

The law can’t reduce costs. It can reduce prices, but not costs. They are not the same thing. Government fiat can dictate lower prices, but it cannot reduce cost of something, which consists of the number of man hours needed to produce something, or the cost of machines used in its production that have to be paid for, or the cost of raw materials needed for its manufacture, etc.

The government can indeed reduce prices—can mandate goods or services shall be priced at X. But when the actual cost of making them is Y, and when X is less than Y, no one can make a profit providing these goods or services, and the business that try to do so go under. That’s how it always works. And that’s why price fixing always leads to shortages.

I am the very model of a Christian Evangelical
I’ve no need for courtesy when fighting things heretical
I know the bible word for word; you’ll find me pedagogical
I have my faith so I’ve no need for ideas that are logical
Atheists and Pagans fall before my wit satirical
They’ll burn in hell just as they should; their cries will be so lyrical
I’m always right, you’re always wrong, my reasoning’s dogmatical
For I’m the very model of a Christian Evangelical

Not completely. There have been trade offs, including longer wait times, and other problems, including shortages of critical personnel. There’s no such thing as a free lunch.

Jefe - 23 July 2009 09:41 PM

There have been wait times for under-peopled disciplines. And under-staffed communities.

And why do you suppose that is? Why are certain disciplines under peopled and certain communities understaffed in Canada, and not in the United States? More importantly, doesn’t it even occur to you to wonder if we won’t see the same result here in the US if we change our system to one based on the Canadian model? If not, why not?

Jefe - 23 July 2009 09:41 PM

But in Canada it is illegal to deny healthcare to citizens.

It might be, but apparently someone needs to tell the cold hard economic facts of life that they aren’t obeying the law.

More than 400 Canadians in the full throes of a heart attack or other cardiac emergency have been sent to the United States because no hospital can provide the lifesaving care they require here.

Most of the heart patients who have been sent south since 2003 typically show up in Ontario hospitals, where they are given clot-busting drugs. If those drugs fail to open their clogged arteries, the scramble to locate angioplasty in the United States begins…

…While other provinces have sent patients out of country – British Columbia has sent 75 pregnant women or their babies to Washington State since February, 2007 – nowhere is the problem as acute as in Ontario.

At least 188 neurosurgery patients and 421 emergency cardiac patients have been sent to the United States from Ontario since the 2003-2004 fiscal year to Feb. 21 this year. Add to that 25 women with high-risk pregnancies sent south of the border in 2007.

I am the very model of a Christian Evangelical
I’ve no need for courtesy when fighting things heretical
I know the bible word for word; you’ll find me pedagogical
I have my faith so I’ve no need for ideas that are logical
Atheists and Pagans fall before my wit satirical
They’ll burn in hell just as they should; their cries will be so lyrical
I’m always right, you’re always wrong, my reasoning’s dogmatical
For I’m the very model of a Christian Evangelical

The choices: Wait in line a little while for public health care, or go bankrupt paying full retail.

Libertarians wanting to limit people’s choices to only one form of health care and using fear to do it? Is it a stretch to think Billy and Saul would prefer to privatize all government services, or just the ones where good money can be made?

SaulOhio, you’re in the same league as idealistic Bible thumpers who blame the victim for not following the Bible closely enough for all his problems. That’s right - the system (in your case, free market) is perfect, humans are the weak ones for not following the system properly. Don’t change or challenge the system and everything will be peachy.

The choices: Wait in line a little while for public health care, or go bankrupt paying full retail.

Try to respond to the actual argument instead of just a straw man distortion of it. When there are critical shortages of personnel, even in emergency services, and patients are unable to receive care—even emergency lifesaving care in some instances—the problems are just a little more severe than “wait in line a little while for public health care.”

I am the very model of a Christian Evangelical
I’ve no need for courtesy when fighting things heretical
I know the bible word for word; you’ll find me pedagogical
I have my faith so I’ve no need for ideas that are logical
Atheists and Pagans fall before my wit satirical
They’ll burn in hell just as they should; their cries will be so lyrical
I’m always right, you’re always wrong, my reasoning’s dogmatical
For I’m the very model of a Christian Evangelical

The choices: Wait in line a little while for public health care, or go bankrupt paying full retail.

Try to respond to the actual argument instead of just a straw man distortion of it. When there are critical shortages of personnel, even in emergency services, and patients are unable to receive care—even emergency lifesaving care in some instances—the problems are just a little more severe than “wait in line a little while for public health care.”

As an American who has lived in Canada for over 35 years, I’ve never had a problem with health care here, nor has anybody I know. The only time I had to wait for a procedure was my doing—I was schedule for a hernia operation but had to cancel at the last moment because I had a bad case of flu and didn’t want to undergo full anesthetic with clogged sinuses, so it was reschedule for a few weeks later. You can quote all sorts of data about Canadian problems, but take a look at the problems in the US, they are larger by orders of magnitude.

I already posted the stats somewhere else but it won’t take you long to look up the infant mortality rate, life expectancy and other indicators of the functioning of the health care systems of the various nations. The US doesn’t look too good, a little third-worldish, if you know what I mean, whereas Europe and Asia do quite fine with their socialized medicine. Canada is in the top few in every category. Go figure!

On that thread I ask to explain to explain what drove those numbers and how universal health care fixed them, you never answered. A quick web search shows that the primary causes of infant mortality rate and life expectancy are life style related. Do you believe that 400# people who drink, smoke, eat fast food and don’t exercise don’t know that that life style is killing them and their children? I’ll ask you again how spending massive amounts of money to tell people what they already know but don’t care about is going to lead to anything but bankruptcy…..

Why is there Something instead of Nothing: No reason or ever knowable reason.

Granted its not perfect, and I never claimed it was.
But not one Canadian walks out of a lengthy hospital stay with expensive procedures required facing the potential of immediate bankruptcy, or worse, denial of coverage over a technicality in the quest for greater profit.

Problem is that the proposal on the table right now is not going to reduce costs at all, just shuffle them around.

An analysis by the Congressional Budget Office showed that Obama’s health care plan would in fact raise the costs, and thereby increase the deficit by billions of dollars. Well unsurprisingly, this is not a popular idea, especially in the current economy. So how then to sell this idea to the American people? Simple: the old bait and switch, which politicians have been doing ever since there have been politicians. You don’t sell the unpopular idea; you package it as something else. People don’t discover what it really is until later when the fallout becomes visible.

For example, one of the inducements dangled before the eyes of voters has been to blame current high costs on scapegoats whom the government can rein in. I’m talking about the high pay of the CEOs of pharmaceutical companies. Unfortunately, the reality is that in an industry where developing just one new drug can cost a billion dollars, the salary of the CEO isn’t all that significant a contributor to the final cost of the medicines produced by his company. Whether the head of a multibillion-dollar pharmaceutical company is paid a several million dollars per year, or works practically for free simply won’t add up to much of a difference in the cost of any drug you buy.

But, getting voters incensed at “those greedy bastards” can get them to support a piece of legislation.

Insurance companies are another scapegoat because they do not insure “pre-existing conditions.” Well of course they don’t. How can they, and stay in business? If everyone could wait until he got sick to take out health insurance, why would anyone buy that insurance while he was well? And without premiums paid by healthy customers, where would insurance companies get the revenue to cover the medical expenses of their sick customers? This may not be “compassionate”, but sometimes cold hard reality just isn’t.

If insurance companies had to accept every customer, even those with pre-existing conditions, it would lead to many people avoiding paying all those premiums… until they finally did get sick and then decided to take out health insurance and let the premiums paid by other people pay for their medical treatment. But that’s not bringing down the cost of health care; it’s merely sticking somebody else with paying those costs. So is subsidizing health care and passing on those costs to the next generation of Americans through government deficit spending.

And let’s not forget rationing, which is what President Obama’s proposed health-care bill actually entails. Under this plan, an official body, made up of doctors, actuaries, economists and other experts collecting a government paycheck (i.e. bureaucrats) will determine which medical procedures are cost-effective and which ones are not. Then it will decide which ones Uncle Sam will pay for, and which ones he won’t. This is being called “cost-controls.” But a rose by any other name is still a rose (and still has thorns); it’s plain, old-fashioned rationing, with a different label stuck on it.

As I said, this is all just going to shift the costs around, not reduce it, because most of the actual causes of those high costs are not being addressed at all. For example, one reason health care costs are so high is the ludicrous cost of malpractice insurance. And this cost is so high because America is currently the most litigious society on earth. We have no deterrent whatever to frivolous lawsuits. The ease with which such suits are brought, and the incredibly high damage awards being handed out have turned the civil courts into a big lotto jackpot for some people, and it has forced the cost of malpractice insurance though into the stratosphere. It is not at all uncommon for a neurosurgeon or a vascular surgeon or other doctor specializing in high-risk, lifesaving medical procedures to pay $200,000 a year or more for the malpractice insurance they are forced to carry in this legal climate. Who do you think pays for this? Patients, of course, in the form of higher doctor fees to cover the insurance, and the insurance companies have to charge higher premiums. This is a big contributor to the high cost of health care. And it doesn’t stop there either. There is a huge hidden cost in the form of “defensive medicine”: tests and procedures that doctors order for no good reason other than to protect themselves from lawsuits.

Even if congress did nothing else at all,tTort reform would yield tens of billions in savings over the long haul, and hugely decrease the cost of health care. But don’t look for it any time soon. Most politicians seem to be lawyers, and even many who aren’t get huge donations from trial lawyers, and since trial lawyers get a third of the money from damage awards…

I am the very model of a Christian Evangelical
I’ve no need for courtesy when fighting things heretical
I know the bible word for word; you’ll find me pedagogical
I have my faith so I’ve no need for ideas that are logical
Atheists and Pagans fall before my wit satirical
They’ll burn in hell just as they should; their cries will be so lyrical
I’m always right, you’re always wrong, my reasoning’s dogmatical
For I’m the very model of a Christian Evangelical

C’mon, Billy, tell us what you’re really afraid of. The government taking more control? Losing value in your health care investments? Afraid of a little competition? Why do you insist on restricting options to only one?

I know the answer, you want to protect America from spending good money after bad, since everything the government wrecks everything it touches. Thanks for the concern, but I have the feeling the government is your preferred scapegoat for all problems regardless of how things turn out.

C’mon, Billy, tell us what you’re really afraid of. The government taking more control? Losing value in your health care investments? Afraid of a little competition? Why do you insist on restricting options to only one?

I know the answer, you want to protect America from spending good money after bad, since everything the government wrecks everything it touches. Thanks for the concern, but I have the feeling the government is your preferred scapegoat for all problems regardless of how things turn out.

And I cannot help but notice you completely fail to address even a single point I raised.

I am the very model of a Christian Evangelical
I’ve no need for courtesy when fighting things heretical
I know the bible word for word; you’ll find me pedagogical
I have my faith so I’ve no need for ideas that are logical
Atheists and Pagans fall before my wit satirical
They’ll burn in hell just as they should; their cries will be so lyrical
I’m always right, you’re always wrong, my reasoning’s dogmatical
For I’m the very model of a Christian Evangelical

And I cannot help but notice you completely fail to address even a single point I raised.

Typical. Which is why I quit posting to these message boards, and will quit again soon enough. People avoid my arguments, misrepresent them, claim I made arguments that I did not, assert their conclusions as self-evident truths while ignoring my arguments and evidence against them, and so on.

I’ve noticed a few people talking about paying for health care, and people going broke doing it, as if being alive and healthy, but broke, is a bad thing compared to being dead or incapacitated by illness. If I have the choice between going broke to pay for cancer surgery or waiting in line till the cancer metastasizes, I choose going broke.

Which brings us to the more fundamental reason for my opposition to socialized medicine. Once it is established that the government has an obligation to care for my health, my life is no longer my own. The government is then calling all the shots, based on its own standards and priorities, which are usually the good of the collective. If you are getting old, and are of no more economic use to the government, it becomes impractical to care for you anymore. Some welfare statists have even talked about the “duty to die”, which is the ultimate expression of the idea that your life is not your own.

“Capitalism without failure is like religion without sin. It doesn’t work.”—Alan Metzer

The choices: Wait in line a little while for public health care, or go bankrupt paying full retail.

As I just said, if its a choice between paying for it, even if I go broke, or waiting in line till my tumor metastasizes, I want to live.

Libertarians wanting to limit people’s choices to only one form of health care and using fear to do it?

!!!!!!!

I’m not the one trying to impose universal health care! THAT is one and only one kind of health care (Unless you are a congressman, in which case you get an entirely different plan. I wonder why?) In a free market, there will be a vast number of choices. Health care savings plans, different varieties of insurance, from comprehensive coverage to catastrophic-only, private charities, and so on. A governemnt plan sweeps all those others aside, as this new one is threatening to do.

You are projecting.

Is it a stretch to think Billy and Saul would prefer to privatize all government services, or just the ones where good money can be made?

If it is a necessary service, if people actually need it, then money can be made doing it. All except the proper, minimal role a government is supposed to serve in protecting our (negative) rights against criminals and foreign invaders.

SaulOhio, you’re in the same league as idealistic Bible thumpers who blame the victim for not following the Bible closely enough for all his problems. That’s right - the system (in your case, free market) is perfect, humans are the weak ones for not following the system properly. Don’t change or challenge the system and everything will be peachy.

Again, you are projecting. It is those who insist on perfect solutions, leaving nobody behind. Nobody ever claimed that free markets are perfect. It is those who would impose governemnt solutions that demand perfection, using every little human failure as an excuse to take more control.

As for my blaming all those government programs for the economic crisis, do you have any actual argument that I am wrong, or is comparing it all to one vaguely similar concept of a religion enough to discredit me? Where is the evidence? Where is the logic? Prove to me I am wrong. Some accidental similarity between my beliefs and some religion isn’t an argument.

You are typical of the people I have to debate on internet forums. You’ve got no actual argument.

“Capitalism without failure is like religion without sin. It doesn’t work.”—Alan Metzer

Back in my old country there are indeed(or at least were when I lived there) waiting lists for certain procedures, as there are waiting lists for care-facilities for the elderly.

The rise in medical costs is bound to cause problems in any system simply because there are now so many more of us, living so much longer while we keep on inventing wonderful and very expensive machines and technologies to keep our bodies from falling apart.

We must accept this reality before the bickering begins.

One also wonders, considering the waistline and diet of the average American, how much unnecessary medical costs are created by the relentless efforts of marketing departments to have us eat tons of garbage that we really don’t need.

Sorry, I must be mistaken here, I know , the market is flawless. “Please pass me the Cheetos, they taste so good after smoking a filterless Camel.”

It seems to me that one has to figure out whether healthcare is a right or a privilege.

Civilized people take the former stance, and I’ll accept that others take the latter.

I have actually heard people say that they thought the water supply should be privatized too.
Perhaps they also think that the breathing of air should be contingent on a certain balance in your bank account.